| Shaken baby syndrome
Shaking can kill young babies – and it doesn’t have to be rough. Jane Bartlett looks at the latest research We all know that babies need to be handled carefully, but an extensive study by scientists at the Royal London Hospital and the Sheffield University sheds new light on how easy it may be to harm or even kill a baby by shaking her. The researchers examined the brains of 53 children believed to be killed by deliberate injury and revealed that even mild shaking can damage nerve fibres in the neck area that control breathing. The subsequent lack of oxygen causes the brain to swell, resulting in brain damage or death. It was thought that this could only be caused by violent shaking, which made the brain bash against the skull. Jennian Geddes, a neuropathologist at the Royal London Hospital, told the New Scientist, ‘We focused on the point where the brain meets the spinal cord. A rocking motion at this point can damage the vital part of the spinal cord that controls breathing.’ Lawyers are anticipating that this new piece of medical research may make it more difficult to secure convictions for killing babies by shaking them. It could also provide a new basis to appeal, for high profile cases like that of Louise Woodward, the British au pair who was convicted in a US court in 1997 for the involuntary manslaughter of an eight-month-old boy in her care. Nobody’s saying that bouncing a baby gently on your knee or other normal play activities would cause any harm. But Dr Geddes warns: ‘You can imagine scenarios that might produce the damage without it being deliberately inflicted. It would have to involve vigorous unsupported movement of the head,’ she says. So this rules out rough play at least until your baby’s crawling, and means taking care to support a newborn’s head if you’re walking with them in your arms.
Babies need this support when they’re held because their head size is very large compared to the rest of their body and their neck muscles are weak. ‘Their brains are immature and more susceptible to damage,’ explains Dr Geddes. A letter published last year in the The Lancet suggested that shaken baby syndrome may be much more common than we think. Dr Robert Minns’ research at the Edinburgh’s Royal Hospital for Sick Children shows that around 25 children per 100,000 may suffer from non-accidental head injury, caused by shaking, hitting or being dropped. Past studies put the figure at less than half this number. Dr Minns believes the average age for such abuse is around two months, not five months as previously thought. Babies living in towns and cities are more vulnerable, and autumn and winter are the most common times for it to happen. Shaking a baby is likely to cause much more damage than hitting them. This was dramatically illustrated by doctors at Birmingham University who used a cracked egg suspended in a jar of water to represent a baby’s skull and cerebro-spinal fluid. They showed that unless the jar was struck hard enough to break the glass, the force of the blow could not make the egg yolk touch the sides. However, when the jar was shaken, the egg yolk quickly became damaged. Many mothers will admit that there are times when looking after a baby is so emotionally demanding, they feel like giving their baby a shake. If Dr Minn’s research is correct, it’s easy to see why an infant may be especially vulnerable at two months. This is the time when sleep deprivation for a nursing mum may be at its worst. The flowers have been binned, the congratulation cards have been taken down and the well-wishers have vanished. You’re alone for long periods with a constantly squalling baby. Colic reaches its peak at six weeks, and can go on for months. If the weather is cold and you’re trapped alone indoors, you feel at your wits end.
‘Mothers shake their babies out of frustration,’ says Jan Pratt, from Cry-sis, an organisation which helps parents with babies who cry constantly. ‘You think: I’ve done everything – you’re fed and dry, there’s nothing wrong with you. That’s when the damage can happen.’ The advice they give at Cry-sis is simple. ‘Put the baby in the cot, shut the door, walk away and have a cup of tea,’ says Jan. ‘Give yourself time to calm down, take deep breaths and then go back and do all the things you tried before: check the nappy, whether they’re hungry, cold, whatever.’ You could ask your partner, mother or a friend to look after your baby for a while to give you a break or, if that’s not possible, get out of the house and take your baby for a walk in the pram. And remember, talking to someone also helps: meet other mums on the iVillage message board or ring a friend, relative, your health visitor, or the Cry-sis helpline. ‘You’re not a dreadful parent or a failure,’ reassures Jan. ‘By taking this action you’re doing the best thing for your baby and your sanity.’
Cry-sis is an organisation which helps people with constantly crying babies. It has a network of counsellors who are available on the phone, 24 hours a day: |